{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T02:48:49Z","timestamp":1793155729124,"version":"4.5.0"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,4,25]],"date-time":"2014-04-25T00:00:00Z","timestamp":1398384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"funder":[{"name":"Committee of \u00d6rebro County Council"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify if gestational diabetes mellitus (<jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content>) is a clinically useful marker of future cardiovascular disease (<jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>) risk and if <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content> combined with other risks (smoking, hypertension or body mass) identifies high\u2010risk groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Population\u2010based matched case\u2013control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>National <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>wedish register data from 1991 to 2008.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A total of 2639 women with a cardiovascular event and matched controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Conditional logistic regression examined associations with <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> before and after adjustment for conventional risk factors and confounders. Effect modification for the association of <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> by body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>), smoking and chronic hypertension was assessed by stratification and interaction testing. Adjustment for diabetes post\u2010pregnancy evaluated its mediating role.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Inpatient diagnoses or causes of death identifying ischemic heart disease, ischemic stroke, atherosclerosis or peripheral vascular disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The adjusted odds ratios (and 95% confidence intervals) for the association of CVD with <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content> are 1.51 (1.07\u20132.14), 2.23 (2.01\u20132.48) for smoking, 1.98 (1.71\u20132.29) for obesity and 5.10 (3.18\u20138.18) for chronic hypertension. In stratified analysis the association of <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content> was only seen among women with <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> \u226525, with an odds ratio of 2.39 (1.39\u20134.10), but only women with a <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> &lt;30 accounted for this increased risk. Adjustment for post\u2010pregnancy diabetes attenuated it somewhat to 1.99 (1.13\u20133.52).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the absence of other recognised cardiovascular risk factors, such as smoking, obesity or chronic hypertension, <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content> is a useful marker of raised <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> risk among women with <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> between 25 and 29.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12754","type":"journal-article","created":{"date-parts":[[2014,4,25]],"date-time":"2014-04-25T06:26:39Z","timestamp":1398407199000},"page":"1530-1536","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":102,"title":["Gestational diabetes mellitus and later cardiovascular disease: a <scp>S<\/scp>wedish population based case\u2013control study"],"prefix":"10.1111","volume":"121","author":[{"given":"H","family":"Fadl","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology School of Health and Medical Sciences \u00d6rebro University \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Magnuson","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Biostatistics \u00d6rebro University Hospital School of Medical Health and Sciences \u00d6rebro University \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"\u00d6stlund","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology School of Health and Medical Sciences \u00d6rebro University \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Biostatistics \u00d6rebro University Hospital School of Medical Health and Sciences \u00d6rebro University \u00d6rebro Sweden"},{"name":"Clinical Epidemiology Unit Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U","family":"Hanson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology School of Health and Medical Sciences \u00d6rebro University \u00d6rebro Sweden"},{"name":"Department of Women's and Children's Health Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Schwarcz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine School of Health and Medical Sciences \u00d6rebro University \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,25]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707943"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2010.02978.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60731-5"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-1713"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc05-2482"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-0706"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-1075"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-009-9350-y"},{"key":"e_1_2_6_10_1","volume-title":"The Swedish Medical Birth Register\u2014A summary of content and quality","author":"Centre for epidemiology, National board of health and welfare","year":"2003"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-450"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2012.01518.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2004.00267.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340701532444"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.40.2.S8"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-s224"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.237"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.1.68"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.02.005"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncpneph0623"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.2217\/WHE.11.34"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp0804872"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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